Method for improved oxygen saturation estimation in the presence of noise

ABSTRACT

The present disclosure relates, according to some embodiments, to devices, systems, and methods for estimating a physiological parameter in the presence of noise. For example, the disclosure relates, in some embodiments, to devices, systems, and methods for assessing (e.g., estimating, measuring, calculating) oxygen saturation (SpO2). Methods of assessing SpO2 may include assessing a noise metric associated with motion artifact. In some embodiments, a percentage (e.g., an empirically determined percentage) of a noise metric may be simply added to the SpO2 estimate to produce a corrected SpO2 estimate. An oximetry algorithm may include, according to some embodiments, combining multiple internal SpO2 estimates and associated noise and/or signal quality metrics (e.g., using a radial basis neural network) to produce a modified (e.g., corrected) SpO2 estimate (e.g., rather than merely selecting the estimate from a finite number of candidates). A modified SpO2 estimate may include little or no movement-based error.

This application is a divisional of U.S. patent application Ser. No.12/165,256, entitled “Method for Improved Oxygen Saturation Estimationin the Presence of Noise,” filed Jul. 3, 2008, which is incorporatedherein by reference in its entirety.

FIELD OF THE DISCLOSURE

The present disclosure relates, in some embodiments, to devices,systems, and methods for estimating oxygen saturation (SpO2).

BACKGROUND OF THE DISCLOSURE

Pulse oximeters typically measure and display various blood flowcharacteristics including but not limited to the oxygen saturation ofhemoglobin in arterial blood. Oximeters pass light through bloodperfused tissue such as a finger or an ear, and photoelectrically sensethe absorption of light in the tissue. The amount of light absorbed isthen used to calculate the amount of the blood constituent (e.g.,oxyhemoglobin) being measured.

The light passed through the tissue is selected to be of one or morewavelengths that are absorbed by the blood in an amount representativeof the amount of the blood constituent present in the blood. The amountof light passed through the tissue varies in accordance with thechanging amount of blood constituent in the tissue and the related lightabsorption.

The optical signal through the tissue may be degraded by noise or otherartifacts. One source of noise is ambient light which reaches the lightdetector. Another source of noise is electromagnetic coupling from otherelectronic instruments. Motion of the patient may also introduce noiseonto the signal. For example, the contact between the detector and theskin, or the emitter and the skin, may be temporarily disrupted whenmotion causes either to move away from the skin. In addition, sinceblood is a fluid, it may respond differently than the surrounding tissueto inertial effects, thus resulting in momentary changes in volume atthe point to which the oximeter probe is attached. Noise may degrade apulse oximetry signal relied upon by a physician, without thephysician's awareness.

An oximetry algorithm may include noise metrics to allow it to quantifyartifacts that degrade SpO2 accuracy. These metrics may be used toreduce the impact of the artifacts on accuracy. For example, thesemetrics may be used to adapt multiple internal filters and to selectfrom multiple internal SpO2 estimates. In cases with motion artifact,the noise metrics generally have a significant negative correlation tothe SpO2 level for typical sensor designs. That is, increased motionartifact usually results in a negative SpO2 bias for transmission-typesensor designs, rather than simply generating zero-mean SpO2 errors.

SUMMARY

Accordingly, a need has arisen for improved noise metrics to correctnegative SpO2 bias associated with artifacts (e.g., movement artifacts).

The present disclosure relates, according to some embodiments, todevices, systems, and methods for estimating a physiological parameterin the presence of noise. For example, the disclosure relates, in someembodiments, to devices, systems, and methods for assessing (e.g.,estimating, measuring, calculating) oxygen saturation (SpO2). Methods ofassessing SpO2 may include assessing a noise metric associated withmotion artifact. In some embodiments, a percentage (e.g., an empiricallydetermined percentage) of a noise metric may be simply added to the SpO2estimate to produce a corrected SpO2 estimate. Indeed, by adding thepercentage of the noise metric, the negative SpO2 bias may be corrected.An oximetry algorithm may include, according to some embodiments,combining multiple internal SpO2 estimates and associated noise and/orsignal quality metrics (e.g., using a radial basis neural network) toproduce a modified (e.g., corrected) SpO2 estimate (e.g., rather thanmerely selecting the estimate from a finite number of candidates). Amodified SpO2 estimate may include little or no movement-based error.

One embodiment includes a device for estimating oxygen saturation in thepresence of noise. The device may include a processor in communicationwith a radial basis neural network, wherein the processor is configuredto receive optical oximetry data, process the optical oximetry data toproduce at least one oxygen saturation estimate, communicate the atleast one oxygen saturation estimate to the radial basis neural network,and receive a modified oxygen saturation estimate comprising less noisebias than the at least one oxygen saturation estimate from the radialbasis neural network, wherein the radial basis neural network isconfigured to define the modified oxygen saturation estimate based atleast in part on combining the at least one oxygen saturation estimatewith corresponding signal quality metrics. The device may also include adisplay in communication with the processor, wherein the display isoperable to display a representation of the modified oxygen saturationestimate.

One embodiment includes a method for estimating oxygen saturation in thepresence of noise. The method may include determining a change inestimated oxygen saturation comprising calculating a difference betweena first estimated oxygen saturation value at a first time and a secondestimated oxygen saturation value at a second time. Additionally, themethod may include determining a change in a saturation noise estimatebetween a first saturation noise estimate and a second saturation noiseestimate, wherein the change in the saturation noise estimate attendsthe change in estimated oxygen saturation. Further, the method mayinclude displaying either the first estimated oxygen saturation value orthe second oxygen saturation value based at least in part on acomparison between the change in the estimated oxygen saturation and thechange in the saturation noise estimate.

One embodiment includes a method for reducing affects of noise in anoxygen saturation estimate. The method may include solving acomputer-implemented radial basis neural network using a training set ofoxygen saturation estimates, wherein the training set of oxygensaturation estimates include a target saturation estimate fromnoise-free data, a noise-perturbed saturation estimate, and metricsassociated with calculating the noise-perturbed saturation estimate.Further, the method may include processing at least one test oxygensaturation estimate that is biased by noise using thecomputer-implemented radial basis neural network to produce a modifiedtest oxygen saturation estimate comprising less noise bias than the atleast one test oxygen saturation estimate.

One embodiment includes a method of detecting hypoxia in a subject. Themethod may include collecting optical oximetry data from a subject,processing the optical oximetry data to produce at least one oxygensaturation estimate, processing the at least one oxygen saturationestimate using a solved, computer-implemented radial basis neuralnetwork to produce at least one modified oxygen saturation estimate, andcomparing the at least one modified oxygen saturation estimate with ahypoxia oxygen saturation threshold.

BRIEF DESCRIPTION OF THE DRAWINGS

Some embodiments of the disclosure may be understood by referring, inpart, to the present disclosure and the accompanying drawings, wherein:

FIG. 1 illustrates a transfer function F(x) according to a specificexample embodiment of the disclosure;

FIG. 2 illustrates oxygen saturation in a non-moving finger as afunction of time using an example algorithm;

FIG. 3 illustrates oxygen saturation from moving fingers as a functionof time using a prior art algorithm;

FIG. 4 illustrates oxygen saturation (SpO2) from moving fingers as afunction of time using a prior art algorithm;

FIG. 5 illustrates oxygen saturation from moving fingers as a functionof time using an algorithm according to a specific example embodiment ofthe disclosure;

FIG. 6 illustrates oxygen saturation from moving fingers as a functionof time using an algorithm according to a specific example embodiment ofthe disclosure; and

FIG. 7 is a block diagram of a device or system for estimating oxygensaturation in the presence of motion artifact.

DETAILED DESCRIPTION

The present disclosure relates, in some embodiments, to devices,systems, and methods for reducing the effects of motion artifact and/ornoise on a physiological parameter measurement. For example, methodsaccording to some embodiments of the disclosure may take into accountphysical limitations on various physiological parameters being monitoredwhen weighting and combining a series of samples and/or measurements.Varying weights may be assigned different measurements. Optionally,measurements may be rejected if unduly corrupt. The averaging period maybe adjusted according to the reliability of the measurements in someembodiments. More specifically, a general class of filters may beemployed in processing the measurements. These filters may usemathematical models which (a) describe how physiological parameterschange in time and/or (b) how these parameters relate to measurement ina noisy environment. The filters may adaptively modify a set ofaveraging weights and/or averaging times to optimally estimate thephysiological parameters.

The present disclosure relates, in some embodiments, to devices,systems, and methods for estimating oxygen saturation (SpO2). Forexample, a method for estimating SpO2 may comprise (a) collectingoptical oximetry data from a subject, and (b) processing the data toproduce at least one oxygen saturation estimate. A system, in someembodiments, may take the natural logarithm of the optical oximetry dataand then bandpass filter the data to get absorption-like data. Abandpass filter may strongly attenuate data below about 0.5 Hz and/orabove about 10 Hz in an attempt to remove out-of-band noise. In otherwords, the bandpass filter may be designed to filter out frequenciesthat are not due to a cardiac pulse. This filtered data may be processedthrough two algorithms: a rate calculator and a saturation calculator.In some embodiments, an oxygen saturation estimate may be furtherprocessed to produce a modified saturation estimate (e.g., corrected toimprove accuracy). This post-processing may comprise modifying thesaturation estimate using a radial basis neural network.

According to some embodiments, the present disclosure relates to methodsfor reducing noise effects in a system for measuring a physiologicalparameter. A plurality of measurements may be generated corresponding toat least one wavelength of electromagnetic energy transmitted throughliving tissue. Selected measurements may be compared with at least oneexpected measurement characteristic. A variable weight may be assignedto each of the selected measurements based on the comparison, therebygenerating a plurality of differently weighted measurements for eachwavelength. A first number of weighted measurements may be averaged toobtain a filtered measurement, the first number varying according to themanner in which weights are assigned to a plurality of successiveweighted measurements. A plurality of filtered measurements may begenerated for each wavelength. The filtered measurements for eachwavelength may be then combined and calculations resulting therefrom maybe adaptively filtered using variable weights based on comparing thecalculations to an expected calculation. A second number of the weightedcalculations may be averaged to obtain a filtered calculation, thesecond number varying according to the manner in which weights areassigned to a plurality of successive weighted calculations.

According to some embodiments, a method for estimating SpO2 may comprisepost-processing and/or alarm handling strategies that include using asaturation noise estimate. For example, the saturation noise estimatemay be used to correct the saturation estimate. Empirical data includesa number of events where the saturation estimate and saturation noiseestimate are mirror images of each other. There are entire cases wherethe saturation estimate and saturation noise estimate are fairly wellcorrelated. Thus, where this is true across a population, a correctedsaturation estimate may be calculated as follows:

Sat′=Sat+k(max(noise−m,0)),

where k and m are determined empirically so as to minimize thesaturation error.

In some embodiments, a saturation noise estimate may be used todetermine whether a change in the saturation estimate is significant.For example, if the saturation noise estimate is high, small changes inthe saturation estimate (e.g., changes that are within the range of thesaturation noise estimate) may not be significant. On the other hand, ifthe saturation noise estimate is small, large changes in the saturationestimate (e.g., changes that exceed the saturation noise estimate) maybe significant. For example, it may be desirable to show only thosechanges in the saturation estimate that have a 95% probability of beingreal. If a change in the saturation estimate is attended by a change inthe saturation noise estimate from 2 points to 12 points, then thesaturation estimate may be held unless the change in the saturationestimate changed by twice that delta (i.e., 2×(12 points−2 points)=20points). It should be noted that the term “points” may refer to percentsaturation, as oxygen saturation is usually displayed in increments of1%, from 0% to 100%. In other words, a single point may correspond to 1%oxygen saturation. It may not be desirable to continue to hold asaturation estimate if the saturation noise estimate drops below what ithad been when the initial decision was made to hold it. For example, ifa saturation estimate changes by 15 points, but the saturation noiseestimate increases from 2 points to 12 points, the saturation estimatemay be held (i.e., 15<20). However, if the saturation noise estimatesubsequently drops to 7 points (now, 2×delta=10 points), then the15-point change in the saturation estimate is more likely to be real.Thus, it may be desirable to discontinue holding the saturationestimate. Alternatively, an assumption may be made that, on average, aheld saturation estimate becomes progressively less accurate at a rateof perhaps 0.2 saturation points per second. In such a case, if thesaturation noise estimate goes from 2 points to 12 points, thesaturation noise estimate may be held for up to 50 seconds (i.e., 10points/0.2 points/second=50 seconds).

A saturation noise estimate may be used, according to some embodiments,to determine the likelihood that the saturation has crossed thesaturation threshold and exceeded some sat-time integral. The sat-timeintegral may be defined as the difference between the oxygen saturationvalue and its associated alarm threshold, integrated over time, such asis described in U.S. Pat. No. 5,865,736, which is incorporated herein byreference. During motion, an alarm may only be raised when thelikelihood that the alarm condition has occurred is high. For example, asaturation of 80 may mean that there is a 50% probability that thesaturation is above 80 and a 50% probability that it is below 80. In theabsence of motion, with a 2 point accuracy spec, the probability thatthat saturation estimate of 80 is below an alarm threshold of 85 isvirtually 100%. But if the saturation noise estimate is 5 points, thenthat saturation is only one standard deviation below the threshold of85. There is about an 84 percent probability that the saturation isbelow the threshold and a 16 percent probability that it is above thethreshold. So, a sat-time integral may be incremented only about 68percent (i.e., the difference between 84% and 16%) as much as in the nomotion case. The noisier the saturation estimate becomes, and the closerthe saturation estimate gets to the alarm threshold, the slower thisalarm integral may be incremented. The alarm integral may be decrementedwhen the saturation estimate goes above the threshold, as this mayindicate a greater probability that the physiological saturation isabove rather than below the alarm threshold. Furthermore, the alarmintegral may be set to zero when the saturation value indicates a veryhigh probability that the physiological saturation is above the alarmthreshold (i.e. the difference between the saturation value and thealarm threshold is more than one or two times the estimate of saturationaccuracy derived from one or more signal quality or noise metricsindicative of saturation accuracy).

A radial basis neural network may be used for saturation estimation,according to some embodiments. A radial basis network may be acomputer-implemented, single-hidden-layer network with n unique inputs,m nodes in the hidden layer, and a single linear node in the outputlayer. A unique feature of a radial basis network, in some embodiments,may be the equation used by its hidden nodes. Each node (a) may receiven inputs, (b) may have n associated weights, and (c) may have a singlebias. The equation for a node's output may be:

y=F(b*distance(x ₁ . . . x _(n) , w ₁ . . . w _(n))),

-   where x₁ . . . x_(n) denotes the inputs,-   w₁ . . . w_(n) denotes the weights,-   b is the bias,-   distance ( ) is the distance between the x and w vectors in an    n-dimensional space, and

F(x)=e ^(−x) ² .

In some embodiments, a transfer function F(x) may only have a highoutput when its input is near zero. This is shown in FIG. 1. Therefore,the output of each radial basis neuron may be a function of how close x₁. . . x_(n) is to the ideal inputs w₁ . . . w_(n), and the size of theregion within which the neuron will output a high value (>0.5) may beproportional to b. The output of a radial basis network, therefore, maybe a function of how close x₁ . . . x_(n) is to the weights for eachhidden neuron. Matrix-based methods for solving (determining) theweights for radial basis networks are known to those skilled in the artof signal processing, and are implemented in commonly used signalprocessing software, such as MATLAB®. A radial-basis neural network withthe previously determined weights may then be implemented in system orapparatus embodying the invention.

Depending on the desired behavior, one skilled in the art of signalprocessing may define the value of b, thus controlling how much overlapthere will be between the areas in the input space that each neuron issensitive to. More overlap may be chosen to maximize coverage of theinput space with a small network. Less overlap may be chosen if theneural net needed to respond very differently within narrow regions ofthe input space.

The ability to solve the weights for a radial basis neural network maypose an advantage over designs that apply some other types of neuralnetworks to the same problem (i.e. accurate estimation of oxygensaturation). For example, training a backpropagation network mayundesirably require that its initial weights be initialized to randomvalues, followed by iterative training. Consequently, the weights mayconverge to very different values in different training sessions on thesame data, and these different values may significantly impact theperformance of the neural net. In contrast a radial basis neural networkpresented with the same training data will always have the same weightsdetermined, making its behavior repeatable.

An engineer skilled in the art of signal processing, in someembodiments, may observe the weights of each hidden neuron to determinethe region of data to which a neuron is sensitive. A backpropagationnetwork, in some embodiments, may require a monotonic transfer functionthat causes a neuron's output to be high over one half of the inputspace, low in the other half, and changing rapidly over limited regionnear the boundary. Thus, in some embodiments, a radial basis network maybe desirable for input spaces containing many local peaks and abackpropagation network may be desirable for inputs containing manyedges.

In some embodiments, a radial basis neural network may receive an inputvector that is well outside of the network's training set. If thiscircumstance is not otherwise addressed, the output of all the hiddennodes may be virtually zero, and the output layer may output whateverits default value (bias) is. However, where an outlying data set isidentified (e.g., by a skilled engineer), an additional node centered onthis data may be specified and added to the hidden layer. This outlyingdata may then be added to the original training set. The output layer,which is always linear, may then be re-solved for the expanded trainingset, without having to redefine the rest of the hidden layer.

The present disclosure relates, according to some embodiments, todevices, systems, and methods for detecting oxygen saturation thatcrosses a threshold and/or falls within a range. For example, a methodmay comprise initiating or ending an alarm when an oxygen saturationestimate is below a threshold (e.g., below about 80%) or above athreshold (e.g., above about 95%). A method may comprise initiating orending an alarm when an oxygen saturation estimate is within a selectedand/or desired range. An alarm may include any type of alert that may beperceived by a human and/or a machine including, for example, a visiblealert, an audible alert, and/or a tactile alert. Non-limiting examplesof a visible alert include the appearance or change in appearance oftext or an icon on a display and/or a blinking light (e.g., a redlight). Non-limiting examples of an audible alert include anintermittent and/or continuous tone and/or playback of a recordedwarning message. Non-limiting examples of a tactile alert includevibration or other movement of an object.

Embodiments of the present invention may facilitate calculation ofcorrected saturation values when only a single saturation value isavailable along with associated signal quality metrics. Further, whenmultiple saturation estimates and associated signal quality metrics arecombined, a corrected saturation value calculated in accordance withpresent embodiments may not have a value between the multiple saturationestimates. Indeed, present embodiments may result in extrapolation aswell as interpolation. It should be noted that, in accordance withpresent embodiments, the combining of saturation values and associatedmetrics to reduce bias may be specific to a sensor model or design. Forexample, combination for a reflectance sensor may differ fromcombination for a transmission sensor.

Some specific example embodiments of the disclosure may be illustratedby one or more of the examples provided herein.

EXAMPLE 1 Breathdown Procedure

Desaturation (hypoxia) was induced by reducing the amount of oxygen inthe breathing gas delivered to the subject. Normoxia (resaturation) wasrestored by reverting to the original breathing gas mixture. Oxygensaturation was assessed on a moving and a non-moving hand.

Five desaturations and resaturations were caused in quick succession.Simultaneous data was collected from the four fingers of the moving handand from one finger of the non-moving hand. The non-motion saturationswere concatenated from each finger of the non-moving hand to form atarget vector containing twenty desaturations (FIG. 2), each of whichhas a minima below 80 percent. The saturations computed from the movinghand by a prior-art algorithm or an algorithm embodying the presentinvention may likewise be concatenated (FIGS. 3-6) to form a test set.Thus, an ideal algorithm should report twenty desaturations below 80percent on both the non-motion and motion data.

EXAMPLE 2 Prior Art Algorithm with Pulse-Synchronous Ensemble Averaging

A prior art algorithm that computes saturation with and withoutpulse-synchronous ensemble averaging was tested. FIG. 3 shows thenon-pulse-synchronous ensemble averaging saturation computed using thedata concatenated from the four moving fingers. Saturations below 80 arecalculated (detected) for only 11 of the 20 desaturations. FIG. 4 showsthe pulse-synchronous ensemble averaging saturation computed using thesame motion data. Saturations below 80 are calculated for only 12 of the20 desaturations. Different desaturations were missed by the twosaturation estimates.

In addition to these two saturation estimates, the same prior artalgorithm also computes two associated error and “saturation age”estimates, wherein each “error” estimate quantifies the degree to whichprocessed two-wavelength photoplethysmographs used to calculate a givensaturation estimate are not correlated, and each “saturation age”estimate quantifies the cumulative filtering (i.e. averaging occurringin each of multiple filtering steps) used in the calculation of a givensaturation estimate. One of the “saturation age” estimates is highlycorrelated with its corresponding error estimates, but the other is not.It has been observed that these age or error estimates are sometimesmirror images of the saturation trace. Therefore, the prior artalgorithm computes five semi-independent inputs that are correlated tosaturations: 2 saturations, 2 error estimates, and 2 rates.

EXAMPLE 3 A Radial Basis Network

A Radial Basis network with 30 hidden neurons was solved for thistraining set of 5 inputs X 20 desaturation events, wherein the solvingcomprised determining the set of weights that minimizes the squareddifference between the output of the Radial Basis neural net and thenon-motion saturation estimate. The output is shown in FIG. 5.

Although the tracing in FIG. 5 contains some short-term noise, thenetwork successfully estimated all 20 desaturations below 80. FIG. 6shows the output of the neural net after further processing by a20-second median filter to mitigate this noise.

FIGS. 3 and 4 show two estimates of oxygen saturation calculated withdifferent signal processing, each of which demonstrate uniqueperturbations due to motion artifact. As the text describes, each traceof oxygen saturations is associated with metrics unique to that trace.FIG. 5 demonstrates that by combining multiple estimates of oxygensaturation, such as those shown in FIGS. 3 and 4, and signal qualitymetrics uniquely associated with each of the multiple estimates, thatembodiments of the present invention may produce a corrected saturationestimate that is significantly more accurate than either of the inputsaturations by itself This is apparent when the trace in FIG. 2 iscompared with the traces represented in FIGS. 3-5.

FIG. 7 is a block diagram of a device or system for estimating oxygensaturation in the presence of motion artifact. The system is generallyindicated by reference number 600. The system 600 (e.g., a computer)includes a processor 602 (e.g., a microprocessor) and a radial basisneural network 604 in communication with one another. The system 600also includes a display 606 in communication with the processor 602. Theradial basis neural network 602 may include a single-hidden-layernetwork and may be computer-implemented. Indeed, the radial basis neuralnetwork 604 may be stored within a memory component of the processor602.

The processor 602 may be configured to receive optical oximetry datafrom a patient or from another source (e.g., a database). Further, theprocessor 602 may be configured to process the optical oximetry data toproduce at least one oxygen saturation estimate. Once the processor 602has produced the at least one oxygen saturation estimate, the processor602 may be configured to communicate the at least one oxygen saturationestimate to the radial basis neural network 604. The radial basis neuralnetwork 604 may be configured to modify the oxygen saturation estimatereceived from the processor 602 to reduce bias caused by motionartifact. For example, the radial basis neural network 604 may beconfigured to define a modified oxygen saturation estimate based oncombining the at least one oxygen saturation estimate received from theprocessor 602 with one or more additional oxygen saturation estimatesand corresponding signal quality metrics to reduce motion artifact bias.Once the modified oxygen saturation estimate has been established by theradial basis neural network 604, the radial basis neural network 604 maybe configured to communicate the modified oxygen saturation estimate tothe processor 602, which may be configured to present a representationof the modified oxygen saturation estimate on the display 606, which maybe communicatively coupled with the processor 602.

As will be understood by those skilled in the art who have the benefitof the instant disclosure, other equivalent or alternative compositions,devices, methods, and systems for estimating oxygen saturation can beenvisioned without departing from the description contained herein.Accordingly, the manner of carrying out the disclosure as shown anddescribed is to be construed as illustrative only.

Persons skilled in the art may make various changes in the shape, size,number, and/or arrangement of parts without departing from the scope ofthe instant disclosure. For example, a device and/or system may includea single computer-implemented network per subject (e.g., patient) or asingle computer-implemented network that serves two or more subjects. Inaddition, the size of a device and/or system may be scaled up or down tosuit the needs and/or desires of a practitioner. Also, where ranges havebeen provided, the disclosed endpoints may be treated as exact and/orapproximations as desired or demanded by the particular embodiment. Inaddition, it may be desirable in some embodiments to mix and match rangeendpoints. All or a portion of an oxygen saturation device and/or systemmay be configured and arranged to be disposable, serviceable,interchangeable, and/or replaceable. These equivalents and alternativesalong with obvious changes and modifications are intended to be includedwithin the scope of the present disclosure. Accordingly, the foregoingdisclosure is intended to be illustrative, but not limiting, of thescope of the disclosure as illustrated by the following claims.

What is claimed is:
 1. A device for estimating oxygen saturation in thepresence of noise, the device comprising: a processor in communicationwith a neural network, wherein the processor is configured to receiveoximetry data, process the oximetry data to produce at least one oxygensaturation estimate, communicate the at least one oxygen saturationestimate to the neural network, and receive a modified oxygen saturationestimate from the neural network comprising less noise bias than the atleast one oxygen saturation estimate, wherein the neural network isconfigured to define the modified oxygen saturation estimate based atleast in part on combining the at least one oxygen saturation estimatewith corresponding signal quality metrics; and a display incommunication with the processor, wherein the display is configured todisplay a representation of the modified oxygen saturation estimate. 2.The device of claim 1, wherein the neural network comprises a radialbasis neural network.
 3. The device of claim 2, wherein the radial basisneural network comprises a single-hidden-layer network.
 4. The device ofclaim 3, wherein the single-hidden-layer network has a plurality ofnodes, and each node of the plurality of nodes includes one or moreassociated weights and a single bias.
 5. The device of claim 4, whereinthe single bias of at least one node of the plurality of nodes is in therange of about 5% oxygen saturation to about 10% oxygen saturation. 6.The device of claim 4, wherein the single bias of at least one node inthe plurality of nodes is in the range of about 1% oxygen saturation toabout 5% oxygen saturation.
 7. The device of claim 1, wherein the neuralnetwork is configured to define the modified oxygen saturation estimatebased at least in part on combining the at least one oxygen saturationestimate with one or more additional oxygen saturation estimates.
 8. Thedevice of claim 7, wherein the modified oxygen saturation estimate has avalue that is not between the values of the at least one oxygensaturation estimate and the one or more additional oxygen saturationestimates.
 9. The device of claim 1, wherein the processor is configuredto compare the modified oxygen saturation estimate with a hypoxia oxygensaturation threshold and to initiate an alarm if the modified oxygensaturation estimate is less than or equal to the hypoxia oxygensaturation threshold.
 10. The device of claim 9, wherein the alarmcomprises one or more of a visible alert, an audible alert, a tactilealert, or any combination thereof
 11. A method for estimating oxygensaturation in the presence of noise, the method comprising: generatingat least one oxygen saturation estimate using the processor;communicating the at least one oxygen saturation estimate to a neuralnetwork using the processor; receiving, at the processor, a modifiedoxygen saturation estimate from the neural network comprising less noisebias than the at least one oxygen saturation estimate, wherein theneural network defines the modified oxygen saturation estimate based atleast in part on combining the at least one oxygen saturation estimatewith corresponding signal quality metrics; and presenting, via theprocessor, a representation of the modified oxygen saturation estimateon a display that is in communication with the processor.
 12. The methodof claim 11, wherein the neural network comprises a radial basis neuralnetwork.
 13. The method of the claim 12, wherein the radial basis neuralnetwork comprises a single-hidden-layer network.
 14. The method of claim13, wherein the single-hidden-layer network has a plurality of nodes,and each node of the plurality of nodes includes one or more associatedweights and a single bias.
 15. The method of claim 11, wherein theneural network defines the modified oxygen saturation estimate based atleast in part on combining the at least one oxygen saturation estimatewith one or more additional oxygen saturation estimates.
 16. The methodof claim 15, wherein the modified oxygen saturation estimate has a valuethat is not between the values of the at least one oxygen saturationestimate and the one or more additional oxygen saturation estimates. 17.The method of claim 11, comprising comparing the modified oxygensaturation estimate with a hypoxia oxygen saturation threshold using theprocessor and initiating an alarm, via the processor, if the modifiedoxygen saturation estimate is less than or equal to the hypoxia oxygensaturation threshold.
 18. The method of claim 11, comprising receivingoximetry data from a pulse oximeter at the processor and generating theat least one oxygen saturation estimate based on the received oximetrydata, using the processor.
 19. A system for estimating oxygen saturationin the presence of noise, the system comprising: a processor incommunication with a radial basis neural network, wherein the processoris configured to process oximetry data to produce at least one oxygensaturation estimate, the radial basis neural network is configured toreceive the at least one oxygen saturation estimate from the processorand to modify the at least one oxygen saturation estimate based oncorresponding signal quality metrics indicative of an accuracy of the atleast one oxygen saturation estimate to define a modified oxygensaturation estimate having less noise bias than the at least one oxygensaturation, and the processor is configured to provide an outputindicative of the modified oxygen saturation estimate.
 20. The system ofclaim 19, wherein the processor is configured to compare the modifiedoxygen saturation estimate with a hypoxia oxygen saturation thresholdand to initiate an alarm if the modified oxygen saturation estimate isless than or equal to the hypoxia oxygen saturation threshold.